First Responders and Treatment for Mental Disorders

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We often hear about the mental health issues associated with our veterans. These include : anxiety, PTSD, depression. These men and women are on the front line, far away from the country they so bravely serve. But there is another group of people, right here in front of us, serving on the front lines in our communities- the first responders. How many times do you see the fire fighters shopping in your local grocery store, or pass by a parked patrol car ? And we pull to the side of the road when an ambulance siren is blasting. But, are we thinking about the person driving that ambulance or squad car or fire engine? We sometimes tend to take them for granted, until we need them. And we will at some point in our life dial 9-1-1, or pull a fire alarm, or await an ambulance dispatched to our home. And we want these responders to be the best that they can be when they arrive. But are they?

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As a community, first responders have an invisible integrity that they believe differentiates them from the general public. When you put on a first responders uniform, you’re expected to be “brave, strong, and courageous-you give help, you don’t ask for help,” said Jeff Dill, a retired firefighter. Correction officers, police and firefighters are trained to recognize and deal with people with mental disorders, but they aren’t always prepared to respond to the pressures they face on a daily basis. ( “Giving Help and Not Asking for It: Inside The Mental Health of First Respnders,” Governing July 7, 2017). I don’t think any of us will ever forget the valiant response from our firefighters, police officers, and paramedics on 9/11. These brave people were running into burning buildings in an attempt to rescue anyone who might still be alive. Hurricanes, floods, earthquakes, all natural disasters, yet these first responders risk it all to help their fellow citizens. The stress of making life and death decisions daily, combined with extreme fatigue brought on by 48 hr. shifts, can and does take an emotional toll.

Indeed the mental health needs of first responders are starting to get more attention in the media. The basic cultures of law enforcement, firefighters, paramedics and other emergency services often make it difficult for first responders to bring up their own issues or deeply troubling events that continue to affect them. They may feel that they knew what they were signing up for, so to speak, but that doesn’t mean that what they may encounter won’t cause them pain, anger, or sadness. These first responders know that they are looked to for calm amid chaos. They sometimes fear that opening up could cost them their jobs. It is the stigma attached to mental health disorders that prevents the first responders from seeking the help they so desperately need.

Significant personal turmoil and risk for mental health disorders can be seen across first responder professions. KUAR, the public radio station for the University of Arkansas, Little Rock, reported on research into the mental health of firefighters, in addition to paramedics , by an assistant professor, Sarah Jones. Her study showed:

13% met criteria for moderate to severe depression

26% displayed signs of post-traumatic stress disorder (PTSD)

25% appeared to be at high risk for suicide

27% demonstrated indicators for moderate to severe anxiety disorder

Even if they don’t experience severe symptoms of a mental disorder, many first responders have said they have trouble sleeping, they are easily angered or withdrawn, and many developed a substance abuse issue. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that about one in five adults or 43.8 million Americans -in the United States was living with a diagnosable mental health disorder in 2013. They also found that 9.3 million Americans considered taking their own lives that year. First responders are certainly part of this statistic, but unfortunately, as compared to the general public, there are often higher rates of mental illness, including substance abuse, addiction, and suicide. Retired Fire Captain, Michael Morse, was quoted as saying, “Because of the extreme things we see in our everyday line of duty.. It’s easy to develop an ‘us and them’ attitude. It’s very tempting to stay with those who understand- and soon family and friends can even be excluded. We have to watch out for that.”

Law enforcement officers, firefighters, paramedics, and other first responders must continually see the worst of human experience. The ravaging effects of fire, the emotional and physical damage caused by accident and abuse, the threat of personal attack, constant stress, and an inability to save everyone they attempt to help take a toll.

So, what can we do to help our first responders get the help that they need? Peer support groups for first responders are emerging across the country to help detect problems before they become serious mental health disorders. Dominic Fraccassa, writer for the San Francisco Chronicle , highlighted what one fire station was doing to help their firefighters. “They are putting peer support managers in the stations . They are trying to create a network so that every station has someone with some sort of training to help identify these issues in their early stages. “ Some retired first responders are giving back by joining stress units that allow the responders to call and talk and possibly be directed to doctors and/or counselors who can help them even further. They become “big brothers” to those responders in need.

Sara Jahnke, a writer in mental health topics ,wrote an article explaining that post traumatic growth is the positive side of a stressful experience. Experiencing trauma can sometimes lead to post traumatic growth. It can springboard them to a better place. Responders see themselves as having strength to pull themselves out of a bad psychological situation and see that they have honed their coping skills. Some develop a keener spirituality, and more of an appreciation for life. If a responder can understand that emotional reactions are not a bad thing- they are a normal part of life. It doesn’t mean that a person will experience these bad feelings for life, or have issues down the road. If these feelings can be managed or resolved when they begin, the prognosis is very good. Instead of suffering with PTSD, these responders can survive and thrive having experienced PTG.( Post Traumatic Growth) Finding a therapist, physician, clergy who can help is a good place to start. Staying connected to a dedicated support system is crucial for recovery and growth.

There is also a group called eHome Heroes that offer video chats to any first responders who need help asap. This allows people who need help to reach out in privacy and not be afraid of the social stigma attached to mental health disorders. These counselors can talk to the person, evaluate them, and then direct them to the medical community that they may need. Some responders may think they are suffering from PTSD, when in reality, they have high anxiety levels. The correct diagnosis can lead to the correct treatment.

We can be hopeful that our first responders can get the help that they need when they need it. With so many programs being implemented to help our first responders, there is a feeling of hopefulness. We, as a society, have to take care of those who take care of us. Just imagine a world without our first responders. I am proud when I hear someone say to a serviceman or women, “Thank you for your service.” I remember a time when that wasn’t said. So, I think it would be nice for a firefighter or a police officer or paramedic to hear the same thing. “Hey, thanks for your service.” You are appreciated.

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